Laying the Foundations of Qihuang: Medicine in the Wei, Jin, and Northern and Southern Dynasties — A 370-Year Span
Pulse Diagnosis Takes Shape, Acupuncture Becomes a Canon, Materia Medica Receives a Comprehensive Commentary, Emergency Formulas Are Compiled — The Formative Period of Chinese Medicine's Technical System
“Medicine and pharmacology are the means on which life and death depend.」 (「夫医药为用，性命所系。」)
— Eastern Jin · Wáng Xīzhī (王羲之), Zatie (《杂帖》)
In 220 CE, Cáo Pī (曹丕) usurped the Han and the Three Kingdoms took shape; in 589 CE, the Sui extinguished the Southern Chén (陈) and the realm was unified once more. In between — a full three hundred and seventy years — the Central Plains saw endless warfare, plagues, displaced populations, mass migrations … an era scholars have called “the longest period of upheaval in Chinese history.”
And yet, it was upon the ruins of blood and fire that Chinese medicine completed its great transition from “canonical foundation” to “technical formation” —
- Wáng Shūhé (王叔和) compiled the Mai Jing (《脉经》), and from that point the cunkou (寸口) method of pulse diagnosis became systematized;
- Huángfǔ Mì (皇甫谧) authored the Zhenjiu Jiayijing (《针灸甲乙经》), and from that point acupuncture possessed a canonical text;
- Gě Hóng (葛洪) compiled the Zhouhou Beiji Fang (《肘后备急方》), and emergency formulas were transmitted across a thousand years;
- Táo Hóngjǐng (陶弘景) assembled the Bencao Jing Jizhu (《本草经集注》), and materia medica gained its “general-use categories” system;
- Léi Xiào (雷敩) established the Lei Gong Pao Zhi Lun (《雷公炮炙论》), and drug processing (paozhi) gained rules to follow;
- Liú Juānzǐ (刘涓子) transmitted the Gui Yi Fang (《鬼遗方》), and external medicine (surgery) gained a text to consult.
If we say that the Qin and Han provided Chinese medicine its “bones,” then the Wei, Jin, and Northern and Southern Dynasties gave it its “flesh” — with bone and flesh together, the body is whole.
At Qihuang Library, today we shall take you back to that age of war and free thought in equal measure, and show how “the foundations of Qihuang” were laid amid the chaos.
I. Historical Background: Why Did an Age of Upheaval Become a Golden Age of Medicine?
“White bones lie exposed in the fields; for a thousand li, no rooster crows.」 (「白骨露于野，千里无鸡鸣。」)
— Late Eastern Han · Cáo Cāo (曹操), Haoli Xing (《蒿里行》)
1. Three Major Background Factors
🔥 Warfare and Recurring Plagues
From the late Han to the Northern and Southern Dynasties, according to Fàn Wénlán’s Outline of General Chinese History (《中国通史》) and Dèng Tiětāo’s General History of Chinese Medicine · Ancient Volume (《中国医学通史·古代卷》), recorded major epidemics numbered dozens — the Jian’an plague (196–220), the Disaster of the Yongjia Reign (307–313), the Hou Jing Disturbance (548–552) — pestilence raged alike in the south and the north.
Zhāng Zhòngjǐng (张仲景), in the Preface to the Shanghan Zabing Lun (《伤寒杂病论·原序》), wrote of his own clan of more than two hundred — in less than ten years, two-thirds had died; seven-tenths of cold-damage cases perished — this was the Jian’an plague in real life.
The pressure of epidemic disease forced generation after generation of physicians to set aside philosophical speculation and turn to the clinic.
🌿 Daoism and Medicine United
With the rise of Wei–Jin “Xuanxue” (玄学, Arcane Learning), Daoism flourished — Gě Hóng and Táo Hóngjǐng were at once great Daoist masters and towering figures of medicine and pharmacology.
“In ancient times, those who followed the Way all practiced medicine alongside, in order to save themselves from imminent disaster.」 (「古之初为道者，莫不兼修医术，以救近祸焉。」)
— Jin · Gě Hóng, Baopuzi · Zaying Pian (《抱朴子·杂应篇》)
The Daoist quest for “transcendence” spurred an enormous number of materia medica, alchemy, and yangsheng (养生, health cultivation) experiments; many methods of drug processing and many formulas were invented in this way — a special period in the history of Chinese medicine, the age of “unity of Dao and medicine (道医一体).”
📜 An Open Intellectual Climate
After the Han elevation of Confucianism as the sole orthodoxy, Wei–Jin Xuanxue flung open the door of free thought. Aristocratic families (menfa shizu 门阀士族) commonly pursued medical study, and the ethos of “if one cannot be a good minister, then one shall be a good physician” first took root. Family-secret recipes and master-disciple lineages flourished as never before in this period.
Source: Dèng Tiětāo, ed., General History of Chinese Medicine · Ancient Volume, People’s Medical Publishing House, 2000, Chapter 3, “Medicine in the Wei, Jin, and Northern and Southern Dynasties.”
2. A Snapshot: What Did Those 370 Years Leave Behind?
| Discipline | Representative Work | Author | Nature |
|---|---|---|---|
| Pulse Diagnosis | Mai Jing (《脉经》), 10 scrolls | Wáng Shūhé | Earliest extant monograph on pulse diagnosis |
| Acupuncture | Zhenjiu Jiayijing (《针灸甲乙经》), 12 scrolls | Huángfǔ Mì | Earliest extant monograph on acupuncture |
| Emergency Formulas | Zhouhou Beiji Fang (《肘后备急方》), 8 scrolls | Gě Hóng | Earliest extant emergency manual |
| Materia Medica | Bencao Jing Jizhu (《本草经集注》), 7 scrolls | Táo Hóngjǐng | Records 730 medicinal substances |
| Drug Processing | Lei Gong Pao Zhi Lun (《雷公炮炙论》), 3 scrolls | Léi Xiào | Earliest extant monograph on paozhi |
| Surgery | Liu Juanzi Gui Yi Fang (《刘涓子鬼遗方》), 5 scrolls | Edited by Gōng Qìngxuān | Earliest extant monograph on surgery |
| Formularies | Xiaopin Fang (《小品方》), 12 scrolls | Chén Yánzhī | Required reading in the Sui and Tang |
| Formularies | Jiyan Fang (《集验方》), 12 scrolls | Yáo Sēngyuán | State formulary of the Northern Zhou |
Six great branches of medicine, all took shape in the Wei, Jin, and Northern and Southern Dynasties — this is the true weight behind the four characters “Qihuang Lays Foundations (岐黄筑基)”.
II. Wáng Shūhé: Father of Pulse Diagnosis, Benefactor of Zhòngjǐng
“The principles of pulse diagnosis are subtle and minute; their forms are hard to distinguish. Wiry, tight, floating, hollow — they shift and resemble one another. Easy to grasp in the mind, hard to discern beneath the fingers.」 (「脉理精微，其体难辨；弦紧浮芤，展转相类；在心易了，指下难明。」)
— Western Jin · Wáng Shūhé, Preface to the Mai Jing (《脉经·序》)
1. The Man
Wáng Shūhé (王叔和), given name Xī (熙), lived c. 201–280 CE, a native of Gāopíng (高平) (in the area of present-day Wēishān, Shāndōng — some say Zōuchéng, Shāndōng), served as Grand Physician of the Western Jin (太医令).
His two immortal achievements:
- First, reorganizing the scattered and partially lost Shanghan Zabing Lun (《伤寒杂病论》) — ensuring that Zhòngjǐng’s teaching was preserved and transmitted;
- Second, compiling the Mai Jing in ten scrolls — ensuring that Chinese pulse diagnosis was from then on systematized and standardized.
Source: Jin · Huángfǔ Mì, Zhenjiu Jiayijing · Preface (《针灸甲乙经·序》); Tang · Gān Bózōng, Mingyi Lu (《名医录》); Song · Lín Yì et al., Collated Preface to the Mai Jing (《脉经·校定序》), Northern Song Bureau of Medical Revisions, 1068.
2. “Zhòngjǐng’s Teaching Was Transmitted Through Shūhé”
In the late Eastern Han, Zhāng Zhòngjǐng (张仲景) composed the Shanghan Zabing Lun in sixteen scrolls, which were scattered and partly lost in the warfare.
Wáng Shūhé, serving as Grand Physician of the Western Jin, gathered the surviving fragments and reorganized the text, producing the Shanghan Lun (《伤寒论》) and the Jingui Yaolüe Fang Lun (《金匮要略方论》) (Note: the name “Jingui Yaolüe” was fixed by later generations, and crystallized in the Song collation).
“Zhāng Zhòngjǐng expanded the Tangye Jing (《汤液经》) into more than ten scrolls, whose use was widely effective. Recently, the Grand Physician Wáng Shūhé compiled and arranged Zhòngjǐng’s remaining teachings with great precision.」 (「张仲景论广《汤液经》为十数卷，用之多验。近世太医令王叔和撰次仲景遗论甚精。」)
— Jin · Huángfǔ Mì, Zhenjiu Jiayijing · Preface (《针灸甲乙经·序》)
This single phrase “compiled and arranged Zhòngjǐng’s remaining teachings with great precision” — is Wáng Shūhé’s first great contribution to Chinese clinical medicine. Without Shūhé, we might today have no Shanghan or Jingui to read.
3. The Mai Jing in Ten Scrolls: The Foundation of a Pulse-Diagnosis System
The Mai Jing (《脉经》), ten scrolls, ninety-seven chapters, composed c. 280 CE, is the earliest extant monograph on pulse diagnosis in China — and in the world.
📊 Three Major Contributions
First, the naming of the twenty-four pulse types: fú (浮, floating), chén (沉, sinking), chí (迟, slow), shuò (数, rapid), huá (滑, slippery), sè (涩, choppy), xū (虚, deficient), shí (实, replete), cháng (长, long), duǎn (短, short), hóng (洪, surging), wēi (微, faint), jǐn (紧, tight), huǎn (缓, moderate), xián (弦, wiry), kōu (芤, hollow), gé (革, drum-skin), láo (牢, firm), rú (濡, soggy), ruò (弱, weak), sǎn (散, scattered), xì (细, thin), fú (伏, hidden), dòng (动, moving) — the twenty-four pulse images were from this point named, shaped, and defined.
“There are twenty-four pulses: floating, sinking, slow, rapid …」 (「脉有二十四：浮、沉、迟、数……」)
— Mai Jing · Scroll One (《脉经·卷一》)
Second, establishing the cunkou three-position nine-indicator method (寸口三部九候): Building on the Nan Jing’s dictum of “taking only the cunkou”, further specifying the cùn (寸), guān (关), chǐ (尺) three positions of both wrists — six positions in all — and the floating, middle, and deep three indicators, forming the standard pulse-taking method of “three positions and nine indicators of the cunkou (寸口三部九候).”
Third, matching pulse, pattern, and formula: The Mai Jing correlates pulse images with disease patterns and formulas, carrying through the line “pulse–pattern–formula (脉病证方)” — laying the foundation for the later clinical paradigm of “combining pulse and pattern (脉证合参)”.
🌏 Transmission Abroad
- Westward to the Arab world: the 11th-century Arab medical master Avicenna (980–1037) and his Canon of Medicine (《医典》), whose pulse-diagnosis section clearly drew on the Mai Jing (the mainstream scholarly view is that it reached the Arabs via the Silk Road or through Persia);
- Eastward to Japan and Korea: it reached Japan in the Nara period, where it became a required medical text;
- Modern translations: in English, French, Russian, Japanese, and Korean, many translations are extant.
Source: Song · Lín Yì et al., collated edition, Preface to the Mai Jing (《脉经·序》); Wáng Xuětái, “Wáng Shūhé” entry, Encyclopedia of Chinese Medicine · Medical History (《中国医学百科全书·医学史》); Joseph Needham, Science and Civilisation in China, Vol. VI: 6, Cambridge University Press, 2000.
4. A One-Line Summary of Wáng Shūhé
“Shūhé’s merit lies both in Zhòngjǐng and in pulse diagnosis; on one hand, he transmitted Zhòngjǐng’s teaching; on the other, he opened the gate of pulse diagnosis.”
Without him, Chinese medicine today would have lost half its territory.
III. Huángfǔ Mì: Founder of Acupuncture, Scholar-Physician
“One who has inherited a body from one’s forebears, a frame of eight Chinese feet, and yet knows nothing of medicine — that is what is called a wandering soul!」 (「夫受先人之体，有八尺之躯，而不知医事，此所谓游魂耳！」)
— Jin · Huángfǔ Mì, Zhenjiu Jiayijing · Preface (《针灸甲乙经·序》)
1. The Man: From “Foolish Child” to “Mister Xuanyan”
Huángfǔ Mì (皇甫谧, 215–282), courtesy name Shì’ān (士安), self-styled Mister Xuanyan (玄晏先生), a native of Āndìng Cháonà (安定朝那) (present-day Língtái, Gānsù).
A great-grandson of the celebrated Eastern Han general Huángfǔ Sōng (皇甫嵩), he was born of noble lineage, yet became one of history’s most famous cases of “late blooming” — before the age of twenty, he “wandered without restraint”, and his neighbors looked upon him as a “foolish child”; after the age of twenty, chastened by his aunt Ladies Shì (任氏), he awakened in a single night, shut his door, took up his books, and at last became a great Confucian scholar.
“People leave their children a chest full of gold; I teach my child but a single classic.」 (「人遗子，金满籯；我教子，惟一经。」)
— Lady Shì’s admonition to Huángfǔ Mì (recorded in the Book of Jin · Biography of Huángfǔ Mì 《晋书·皇甫谧传》)
2. “Taking Illness as the Origin of Medicine”: A Case of Wind-Impediment, a Resolve to Write
At the age of forty-two, Huángfǔ Mì fell prey to wind-impediment disease (风痹), half his body was paralyzed, a hundred remedies availed nothing, and he nearly took his own life.
It was precisely this grave illness that led him to resolve to study medicine, “to collect the three texts — the Suwen, the Zhenjing, and the Mingtang Kongxue Zhenjiu Zhiyao — to prune their superfluous words, eliminate their repetitions, distill their essentials”, and to “compile the Zhenjiu Jiayijing.”
“I therefore gathered the three texts, arranging them by subject matter, pruned their superfluous words, eliminated their repetitions, and distilled their essentials, producing a work of twelve scrolls.」 (「乃撰集三部，使事类相从，删其浮辞，除其重复，论其精要，至为十二卷。」)
— Huángfǔ Mì, Zhenjiu Jiayijing · Preface (《针灸甲乙经·序》)
Testing the method on his own body, writing the book out of his own disease — “the Medicine Sage” Zhāng Zhòngjǐng did so; “the Acupuncture Sage” Huángfǔ Mì did likewise.
3. The Zhenjiu Jiayijing: The “Inner Canon” of Acupuncture
The Zhenjiu Jiayijing (《针灸甲乙经》), full title Huángdì Sānbù Zhēnjiǔ Jiǎyǐ Jīng (《黄帝三部针灸甲乙经》, The Yellow Emperor’s Acupuncture A, B, C Classic in Three Parts), 12 scrolls, 128 chapters, c. 110,000 characters, composed c. 256–282 CE, is the earliest extant and most complete monograph on acupuncture in China, revered by later generations as “the Neijing of acupuncture”.
📊 Four Major Contributions
First, defining 349 acupoints: 349 points on the whole body, 300 bilateral points, 49 midline points, arranged by region — head, face, chest, abdomen, back, and limbs — each point’s location, indications, needling method, and contraindications are all set out in full.
“Directly above the nose, entering the hairline five fen … (Baihui point)」 (「头直鼻中入发际五分……（百会穴）」)
— Zhenjiu Jiayijing · Scroll Three (《针灸甲乙经·卷三》)
Second, instituting the “arrange by region” method for acupoints: Moving beyond the cumbersome “arrange along the meridian” method of the Lingshu, he adopted “arrangement by bodily region” — of great practical value in the clinic, a method still used today.
Third, standardizing needling and moxibustion techniques: Needle depth, needle retention time, tonifying–reducing methods, moxa-cone number, prohibited points — forming a complete operational standard for needling and moxibustion for the first time.
Fourth, taking the first steps toward “Zi-Wu Liu-Zhu (子午流注)”: The early ideas of “Ying–Sui tonifying and reducing (迎随补泻)” and of chrono-acupuncture begin to appear in this text.
🌏 Influence Across a Millennium
- Tang dynasty: required text in the acupuncture division of the Imperial Medical Academy (太医署);
- Song dynasty: the basis for Wáng Wéiyī’s (王惟一) Illustrated Manual of Acupoints on the Bronze Figure (《铜人腧穴图经》);
- Ming dynasty: the direct source of Yáng Jìzhōu’s (杨继洲) Zhenjiu Dacheng (《针灸大成》);
- Abroad: in Japan it was called the “Bible of Acupuncture”; in Korea, the Euibang Yuchwi (《医方类聚》) cited it hundreds of times.
Source: People’s Medical Publishing House, Collated and Annotated Zhenjiu Jiayijing (《针灸甲乙经校释》), 1996; Book of Jin · Biography of Huángfǔ Mì (《晋书·皇甫谧传》), compiled by Táng · Fáng Xuánlǐng (房玄龄).
4. A One-Line Summary of Huángfǔ Mì
“Without the Jiayi, there would be no canon of acupuncture; without Huángfǔ Mì, there would be no science of acupuncture.”
IV. Gě Hóng: Dao and Medicine United, Saving the World in Emergencies
“Embrace the uncarved block and hold the One; be tranquil, indifferent, and few in desire.」 (「抱朴守一，恬淡寡欲。」)
— Jin · Gě Hóng, Baopuzi (《抱朴子》)
1. The Man: Daoist, Chemist, Physician
Gě Hóng (葛洪, 283–343), courtesy name Zhìchuān (稚川), self-styled Baopuzi (抱朴子, “Master Who Embraces Simplicity”), a native of Dānyáng Jùróng (丹阳句容) (present-day Jùróng, Jiāngsū).
A triple identity:
- Great Daoist master — the founding father of the “Danding (丹鼎, Elixir-Cauldron) school”;
- Pioneer of chemistry — through his alchemical practice he observed a great many chemical reactions, and his Baopuzi · Inner Chapters (《抱朴子·内篇》) is an important document in the early history of chemistry in China;
- Physician — his Zhouhou Beiji Fang (《肘后备急方》) lives forever in human memory.
Source: Book of Jin · Biography of Gě Hóng (《晋书·葛洪传》), compiled by Táng · Fáng Xuánlǐng; Wáng Míng, Collated and Annotated Baopuzi Neipian (《抱朴子内篇校释》), Zhonghua Book Company, 1985.
2. The Zhouhou Beiji Fang: A Pocket Emergency Manual
The Zhouhou Beiji Fang (《肘后备急方》), originally named Zhouhou Jiu Zu Fang (《肘后救卒方》), 3 scrolls (expanded by Liáng · Táo Hóngjǐng to Zhouhou Baiyi Fang (《肘后百一方》), 6 scrolls, and further supplemented in the Jin dynasty by Yáng Yòngdào into Ge Xianweng Zhouhou Beiji Fang (《葛仙翁肘后备急方》), 8 scrolls), composed c. 340 CE.
The two characters “Zhouhou (肘后)”, meaning “a small book that can be hung behind one’s elbow to carry on one’s person” — this is China’s earliest “portable emergency manual.”
📜 Stylistic Features
In the Preface to the Zhouhou Beiji Fang, Gě Hóng made clear:
- “I have selected the essentials, and made of them the Zhouhou Jiu Zu Fang in three scrolls.”
- His principle of selection: “I have chosen mostly medicines easy to obtain and materials of low cost; those that unavoidably must be bought are likewise cheap herbs and minerals easy to beg for.”
Cheap, easy to obtain, easy to prepare, easy to remember — this is “a medical book written for the poor.”
📊 Five World-Firsts
First, description of smallpox (c. 311 CE):
“In recent years there has been a pestilence of the season … it produces sores on the head, face, and body; in a moment they spread all around, looking as if burned by fire, all bearing white fluid.」 (「比岁有病时行……发疮头面及身，须臾周匝，状如火疮，皆带白浆。」)
— Zhouhou Beiji Fang · Formulas for Cold-Damage, Seasonal, and Pestilential Fevers (《肘后备急方·治伤寒时气温病方》)
This is one of the earliest clinical descriptions of smallpox in the history of world medicine, predating the description by the Arab physician Rhazes (c. 860–925) by roughly 600 years.
Second, description of tsutsugamushi disease (sand-mite disease): “The sand-mite … when it touches a person’s skin it burrows into the skin“ — the earliest record of tsutsugamushi disease in world medical history.
Third, rabies treated by “fighting poison with poison”:
“Then kill the dog that bit the patient, take its brain, and apply it to the wound; thereafter it will not recur.」 (「仍杀所咬犬，取脑敷之，后不复发。」)
— Zhouhou Beiji Fang · Formulas for the Bite of a Mad Dog (《肘后备急方·治卒有猘犬凡所咬毒方》)
This is the earliest germ of immunological thought — in 1885, the Frenchman Louis Pasteur (巴斯德) used his rabies vaccine to save the boy Joseph Meister — whereas Gě Hóng preceded him by some 1,500 years.
Fourth, qinghao (sweet wormwood) for malaria:
“Take a handful of qīnghāo (青蒿, sweet wormwood), soak in two shēng of water, wring out the juice, and drink it all.」 (「青蒿一握，以水二升渍，绞取汁尽服之。」)
— Zhouhou Beiji Fang · Formulas for Treating Cold-Heat and Various Malarias (《肘后备急方·治寒热诸疟方》)
These eight characters directly inspired Tū Yōuyōu 1,700 years later — in 2015 she received the Nobel Prize in Physiology or Medicine for artemisinin, and in her Stockholm lecture she read aloud these eight characters:
“This source of inspiration led us to switch to a low-boiling-point solvent for extraction; on 4 October 1971 we obtained sample No. 191, which inhibited 100% of the rodent malaria parasites.」
— Tū Yōuyōu’s 2015 Nobel Lecture (nobelprize.org)
Fifth, tuberculosis, leprosy, and beriberi: All received the first detailed clinical records here.
Source: People’s Medical Publishing House, Collated and Annotated Zhouhou Beiji Fang (2016); Tū Yōuyōu, “Artemisinin: A Gift from Traditional Chinese Medicine to the World,” Nature, 2011; nobelprize.org biography of Tū Yōuyōu.
3. A One-Line Summary of Gě Hóng
“Above he could refine the elixir and seek the Dao; below he could rescue the dying at his elbow; in between he could transform the people and save the world — this is the true ‘unity of Dao and medicine.’“
V. Táo Hóngjǐng: Prime Minister of the Mountains, Great Compiler of Materia Medica
“What is there in the mountains?
On the ridge, much white cloud.
It may delight only oneself,
Not fit to give as a gift to you.」 (「山中何所有？岭上多白云。只可自怡悦，不堪持赠君。」)— Southern Liáng of the Southern Dynasties · Táo Hóngjǐng, On Being Asked What Is in the Mountains, I Answer in Verse (《诏问山中何所有赋诗以答》)
1. The Man: “Prime Minister of the Mountains”
Táo Hóngjǐng (陶弘景, 456–536), courtesy name Tōngmíng (通明), self-styled Huáyáng Yǐnjū (华阳隐居, “Hermit of Mount Huáyáng”) and Huáyáng Zhēnrén (华阳真人, “Perfected Person of Huáyáng”), a native of Dānyáng Mòlíng (丹阳秣陵) (present-day Nánjīng, Jiāngsù).
He was the founding patriarch of the Māoshān (茅山) school of Daoism, and also the most respected extra-court advisor of Emperor Wǔ of Liáng (梁武帝 Xiāo Yǎn) — Emperor Wǔ, whenever a great matter arose, always sent a courier to consult him, and for this reason his contemporaries called him the “Prime Minister of the Mountains (山中宰相)”.
2. The Bencao Jing Jizhu: A Bridge Between Past and Future in Materia Medica
The Bencao Jing Jizhu (《本草经集注》), 7 scrolls, composed c. 500 CE, is Táo Hóngjǐng’s comprehensive reorganization and supplementation of the Shennong Bencao Jing (《神农本草经》) — inheriting the ancient Benjing and opening the way to the Xinxiu Bencao (《新修本草》).
📊 Three Major Contributions
First, recording 730 medicinal substances:
- The Benjing originally listed 365 substances;
- Táo supplemented 365 more from the Mingyi Bielu (《名医别录》);
- 730 substances in all,
- For the first time the “Shennong’s herbs” and the “famous physicians’ herbs” were placed within a single book — distinguished by writing the Benjing in red ink and the Bielu in black ink.
Second, originating the “General-Use Categories (诸药通用)” classification: Breaking free from the crude “three-grade classification” (superior, middle, inferior), he reclassified medicinals by source, property, and indication into: minerals, plants, insects-and-beasts, fruits, vegetables, grains-and-foods, and “famous but unused” — seven categories in all.
This was a revolution in the classification of Chinese materia medica — it laid the foundation for a thousand-year tradition of “classification by natural property”, and the sixteen-section classification of Lǐ Shízhēn’s Bencao Gangmu (《本草纲目》) is the culmination of this very tradition.
Third, standardizing drug names, places of origin, collection, processing, and use:
- The idea of “genuine-region medicinals (道地药材)” was initially systematized — “Since the Jiāngdōng period, the small miscellaneous drugs … today are produced near the roads and found everywhere … only the people of Jiāngdōng know few medicinal materials” (Bencao Jing Jizhu · Preface 《本草经集注·序》).
- Collection seasons: clearly specifying the best harvest season for each drug.
- Processing methods: for the first time, systematic records of removing the root-stock, removing the hair, removing the core, slicing, and other processing essentials.
“To treat disease with medicine is like feeding the hungry or giving drink to the thirsty.」 (「疾病而救之以药，犹饥而食、渴而饮也。」)
— Táo Hóngjǐng, Bencao Jing Jizhu · Preface (《本草经集注·序》)
🌏 Transmission and Influence
- In the Tang, Sū Jìng’s (苏敬) Xinxiu Bencao (《新修本草》), completed in 659 CE, took the Jizhu as its blueprint;
- Surviving fragments of the Bencao Jing Jizhu have been recovered from the Dunhuang and Turfan sites — held in museums in Paris, London, and Japan.
Source: Shàng Zhìjūn and Shàng Yuánshèng, Collated Reconstruction of the Bencao Jing Jizhu (《本草经集注（辑校本）》), People’s Medical Publishing House, 1994; Bibliothèque nationale de France Dunhuang manuscript P.3714 (a fragment of the Bencao Jing Jizhu · Xulu 《本草经集注·序录》).
3. A One-Line Summary of Táo Hóngjǐng
“From Master Tao onward, the Bencao had its pattern, its classification, its genuine-region tradition, and its processing methods — no one but Master Tao can be called the father of bencao studies.”
VI. Léi Xiào: Establishing the Law of Drug Processing, Returning Medicine to Its Source
“All medicines must be prepared by the methods of paozhi before they can be entered into a formula.」 (「凡药须修事炮炙，乃可入剂。」)
— Southern Dynasties · Léi Xiào, Lei Gong Pao Zhi Lun · Preface (《雷公炮炙论·序》)
1. The Man
Léi Xiào (雷敩), dates of birth and death unknown, a person of the Liúsòng (刘宋) period of the Southern Dynasties (some say Southern Qí), the founding father of the science of drug processing (paozhi).
2. The Lei Gong Pao Zhi Lun: The Founding Monograph of Paozhi
The Lei Gong Pao Zhi Lun (《雷公炮炙论》), 3 scrolls, composed c. 470 CE, records 300 medicinal substances, and is the first systematic treatment of the science of paozhi (炮制, drug processing).
📊 Seventeen Fundamental Processing Methods
Léi Xiào established the “Seventeen Methods of Paozhi (炮制十七法)” —
| Category | Method | Examples |
|---|---|---|
| Fire preparation | Pao (炮, blast-frying), zhi (炙, broiling), duan (煅, calcining), wei (煨, roasting in embers), chao (炒, stir-frying) | Fuzi (aconite) blast-fried, Gancao (licorice) broiled |
| Water preparation | Zi (渍, soaking), pao (泡, steeping), xi (洗, washing), piao (漂, rinsing), shuifei (水飞, water-grinding) | Zhusha (cinnabar) water-ground |
| Water-and-fire combined | Zheng (蒸, steaming), zhu (煮, boiling), cui (淬, quenching), chan (燀, scalding) | Heshouwu (fleeceflower root) steamed nine times and sun-dried nine times |
| Processing with辅料 | Wine, vinegar, salt, ginger, honey, boy’s urine | Danggui (angelica) wine-prepared; Xiangfu (cyperus) vinegar-prepared |
“Steaming nine times and sun-drying nine times”, “steaming with wine”, “broiling with honey” — these paozhi terms still in use today all derive from the Lei Gong Pao Zhi Lun.
3. A One-Line Summary of Léi Xiào
“The same herb, processed or unprocessed, is two different medicines; the same method, once established by the Master of Thunder, has not changed in a thousand years.”
VII. Liú Juānzǐ’s Gui Yi Fang: The First Book of Surgery
1. Origin
The Liu Juanzi Gui Yi Fang (《刘涓子鬼遗方》), authored by Liú Juānzǐ (刘涓子) of the Liúsòng (刘宋) period of the Southern Dynasties, and collated and arranged by Gōng Qìngxuān (龚庆宣) of the Southern Qí, composed in the late 5th century CE, originally 10 scrolls, of which 5 survive, is the earliest extant monograph on surgery in China.
The two characters “gui yi (鬼遗, ‘bequeathed by a ghost’)” come, according to tradition, from the story that Liú Juānzǐ met a yellow-headed ghost in a dream and received the formulas — in fact, a borrowed name to spread the work — the same as the Benjing’s borrowing of “Shennong” and the Neijing’s borrowing of “Yellow Emperor.”
2. Highlights of the Content
- Diagnosis and treatment of abscesses and ulcers (yōng jū 痈疽): distinguishing the difference between yōng (痈, abscess) and jū (疽, deep-rooted ulcer), and describing in detail the three methods of tuoli (托里, “expelling from within”), neixiao (内消, “resolving internally”), and waifu (外敷, “applying externally”);
- Wound and trauma care: formulas and treatment of metal wounds, traumatic injuries, and burns;
- Skin diseases: specialized formulas for xuan (癣, ringworm), chuang (疮, sores), and lou (瘘, fistulas);
- Some 140 formulas are recorded, the majority being external applications — early exemplars of ointments, powders, and plasters.
The “internal + external” two-track system of Chinese external medicine was established from this point onward.
Source: Zhongyi Guji Chubanshe (Chinese Ancient Medical Texts Publishing House) facsimile edition, Liu Juanzi Gui Yi Fang, 1986; Recorded in the “Medical Formula Section” of the Book of Sui · Treatise on the Classics (《隋书·经籍志》).
VIII. The Flourishing of Formula Books: Chén Yánzhī, Yáo Sēngyuán, and Fàn Wāng
“Formulas are made to suit disease; books are the tools for saving the world.」
1. Chén Yánzhī’s Xiaopin Fang
Chén Yánzhī (陈延之), of the 4th–5th centuries CE, a person of the Southern Dynasties, authored the Xiaopin Fang (《小品方》) in 12 scrolls — “the most practical formulary since the Jiāngzuǒ period“.
The Tang physicians Sūn Sīmǐao (孙思邈) and Wáng Tāo (王焘) quoted it extensively in their compilations; in Japan, it was made a required medical text in the Heian period; the original was lost after the Song, but in 1985 a fragmentary old manuscript was discovered at the Ninna-ji (仁和寺) in Japan, to the consternation of the academic world.
2. Yáo Sēngyuán’s Jiyan Fang
Yáo Sēngyuán (姚僧垣, 499–583), Imperial Physician of the Northern Zhou, authored the Jiyan Fang (《集验方》) in 12 scrolls — “the most important formulary of the Northern Dynasties“.
Wáng Tāo’s Wàitái Mìyào (《外台秘要》) in the Tang quoted it extensively; the original is lost, but most of it survives thanks to the Wàitái.
3. Fàn Wāng’s Fan Wang Fang
Fàn Wāng (范汪, c. 308–372), a famous official of the Eastern Jin, authored the Fan Wang Fang (《范汪方》) in 176 scrolls (some say more than a hundred), “the first formulary of the Eastern Jin“ — the original is lost, but fragments survive scattered through the Yixinfang (《医心方》) and the Wàitái Mìyào.
Source: “Medical Formula Section” of the Book of Sui · Treatise on the Classics (《隋书·经籍志》); Mayanagi Makoto, “Study of the Xiaopin Fang Manuscript Fragments at Ninna-ji, Japan,” Kitasato Oriental Medicine (《北里东洋医学》), Vol. 11, 1985.
IX. Institutions and Education: The Proto-Imperial Medical Academy
1. The 20th Year of Yuanjia, Song of the Southern Dynasties (443 CE)
In 443 CE, the 20th year of the Yuánjiā (元嘉) reign of Emperor Wén of Liúsòng (宋文帝 Liú Yìlóng), “the Grand Physician Qín Chéngzǔ (秦承祖) memorialized the throne to establish a medical academy, in order to broaden the teaching of medicine“ (Tongdian · Scroll 14 · Imperial Medical Academy 《唐六典·卷十四·太医署》) — the formal starting point of official medical education in China.
2. The Taihe Years of the Northern Wei
In the Tàihé (太和) years (477–499 CE) of Emperor Xiào of Northern Wèi (北魏孝文帝), the posts of Grand Medical Erudite (太医博士) and Grand Medical Assistant Instructor (太医助教) were established — the beginning of systematized medical education in the North.
3. North–South Medical Exchange
The Southern Dynasties: emphasized Daoism, yangsheng, materia medica, and formula books — Gě Hóng, Táo Hóngjǐng, and Liú Juānzǐ are representative.
The Northern Dynasties: emphasized clinical practice, acupuncture, official schooling, and drug pairing — Xú Zhīcái (徐之才) and Yáo Sēngyuán are representative.
The merger of North and South provided the complete nourishment for the great flourishing of medicine in the Sui and Tang.
X. Xú Zhīcái and the “Drug-Pairing” School
Xú Zhīcái (徐之才, 505–572), a famous physician of the Northern Qí, came from the Xú family medical lineage (following Xú Wénbó (徐文伯) and Xú Sìbó (徐嗣伯)), the culminating figure of “eight generations of Xú family physicians (徐氏八世医)”.
He authored the Yao Dui (《药对》, Drug Pairings) in 2 scrolls (also called the Lei Gong Yao Dui (《雷公药对》)) — the first systematic treatment of “drug compatibility (药物配伍)”, and the doctrine of “drugs have xiāngxū, xiāngshǐ, xiāngwèi, xiāngwù, xiāngfǎn, xiāngshā (相须, mutual reinforcement; 相使, mutual assistance; 相畏, mutual restraint; 相恶, mutual aversion; 相反, opposition; 相杀, mutual suppression)” was now made clinically operational.
The enormous body of experience underlying the later theory of “chief, deputy, assistant, envoy (君臣佐使) compatibility” traces back to this single Xú lineage.
Source: Book of Northern Qí · Biography of Xú Zhīcái (《北齐书·徐之才传》), compiled by Táng · Lǐ Bǎiyào (李百药); Fàn Xíngzhǔn, Brief History of Chinese Medicine (《中国医学史略》), Zhongyi Guji Chubanshe, 1986.
XI. Sino-Foreign Medical Exchange: Buddhist Medicine and “Hu” Drugs
1. Indian Medicine Enters China
Buddhism had entered China in the late Eastern Han, and with it came Indian medicine —
- The Foshuo Foyi Jing (《佛说佛医经》) (translated in the Wu period by Zhúlǜyán and Zhīqiān) — the Indian “Four Greats (四大, earth-water-fire-wind) doctrine of disease causation first entered China;
- The Jiaye Xianshuo Yi Nüren Jing (《迦叶仙人说医女人经》) (translated in the Northern Wèi) — bringing Indian obstetrical and gynecological knowledge into China.
2. “Hu” Drugs Enter China
Along the Silk Road, “Hu” (foreign) drugs — rǔxiāng (乳香, frankincense), mòyào (没药, myrrh), ānxīxiāng (安息香, benzoin), sūhéxiāng (苏合香, storax), shèxiāng (麝香, musk), xījiǎo (犀角, rhinoceros horn), āwèi (阿魏, asafoetida) — poured into China in abundance, and Táo Hóngjǐng’s Bencao Jing Jizhu recorded many of these “Hu” drugs for the first time.
3. Chinese Medicine Travels Westward
In the Northern Wèi and Southern Dynasties, the Korean peninsula (the kingdoms of Gāogōulí 高句丽, Bǎijì 百济, and Xīnluó 新罗) and Japan sent envoys to seek medical knowledge, bringing back a great many Chinese medical texts — the official medical systems of Korea’s “Bangsi (方士, medical officials)” and Japan’s “Tenyakuryō (典药寮, Bureau of Medicine)” all began in this period.
Source: Chén Bāngxiān, History of Chinese Medicine (《中国医学史》), Commercial Press, first edition 1937; Dèng Tiětāo, ed., General History of Chinese Medicine · Ancient Volume.
XII. Medicine in the Wei, Jin, and Northern and Southern Dynasties: A Master Table
“Three hundred and seventy years of turmoil, and the medical Way became instead a golden age.」
| Period | Dynasty | Physician | Representative Work | Contribution |
|---|---|---|---|---|
| 220–265 | Cáo Wèi | (Huà Tuó’s disciples Wú Pǔ 吴普, Fán Ā 樊阿) | Five-Animal Frolic, transmitted teachings | Continuation of Huà Tuó’s medical Way |
| 265–316 | Western Jin | Wáng Shūhé | Mai Jing (《脉经》), 10 scrolls | Pulse diagnosis systematized; reorganized the Shanghan |
| 256–282 | Western Jin | Huángfǔ Mì | Zhenjiu Jiayijing (《针灸甲乙经》), 12 scrolls | First text of acupuncture; 349 points |
| 283–343 | Eastern Jin | Gě Hóng | Zhouhou Beiji Fang (《肘后备急方》) | Emergency manual; qinghao for malaria; rabies treated by fighting poison with poison |
| 308–372 | Eastern Jin | Fàn Wāng | Fan Wang Fang (《范汪方》), 176 scrolls | First formulary of the Eastern Jin (lost) |
| 4th–5th c. | Southern Dynasties | Chén Yánzhī | Xiaopin Fang (《小品方》), 12 scrolls | Clinical formulary; transmitted to Japan |
| Late 5th c. | Liúsòng | Liú Juānzǐ (collated by Gōng Qìngxuān) | Liu Juanzi Gui Yi Fang (《刘涓子鬼遗方》) | First book of surgery |
| 5th c. | Southern Dynasties | Léi Xiào | Lei Gong Pao Zhi Lun (《雷公炮炙论》) | First book of paozhi; seventeen methods |
| 456–536 | Southern Liáng | Táo Hóngjǐng | Bencao Jing Jizhu (《本草经集注》), 7 scrolls | Materia medica with 730 substances; “general-use categories” |
| 505–572 | Northern Qí | Xú Zhīcái | Yao Dui (《药对》), 2 scrolls | Drug-compatibility school |
| 499–583 | Northern Zhou | Yáo Sēngyuán | Jiyan Fang (《集验方》), 12 scrolls | First formulary of the Northern Dynasties (preserved by the Wàitái) |
Ten great physicians, ten great classics, full disciplinary coverage, a complete technical system — this is “Qihuang Lays Foundations”.
XIII. Why Is the Wei, Jin, and Northern and Southern Dynasties the “Foundation-Laying Period” of Chinese Medicine?
1. From “Classics” to “Disciplines”
The four great classics of the Qin and Han (Neijing, Nan Jing, Shanghan, Benjing) laid the foundation of Chinese medicine’s “principle, method, formula, and medicine (理法方药)”; the Wei, Jin, and Northern and Southern Dynasties, on this foundation, branched out into six disciplines — pulse diagnosis, acupuncture, materia medica, formularies, paozhi, and external medicine, each with its own text and its own representative master.
From this point on, Chinese medicine was no longer “an undifferentiated mass of tradition”, but “a tree of disciplines with spreading branches and abundant leaves.”
2. From “Literature” to “Clinic”
Zhòngjǐng, before them, set the rules of “clinical medicine”; Shūhé, Shì’ān, Zhìchuān, and Yǐnjū, after him, made “clinical medicine” truly teachable, learnable, and usable.
“Principle, method, formula, and medicine — each had its home“ — this was the collective contribution of the physicians of the Wei, Jin, and Northern and Southern Dynasties.
3. From “Central Land” to “China and Beyond”
Indian Buddhist medicine and Persian “Hu” drugs entered China, Korea and Japan sent envoys to seek Chinese medical learning — the internationalization of Chinese medicine can be traced back to this very period.
4. From “Official Schooling” to “Official + Private Schooling” in Parallel
In 443 CE of the Southern Liúsòng, official medical education was established; meanwhile, family lineages such as the “Eight Generations of Xú Physicians” and the Gě family line flourished brilliantly — the dual-track system of “official + private schooling (官学+私学)” was established from this point.
XIV. Echoes in the Modern World
🌿 Tū Yōuyōu and Gě Hóng
In December 2015, in Stockholm, Tū Yōuyōu (屠呦呦) stood on the Nobel Prize podium, and recited the eight characters written by Gě Hóng in 340 CE:
“Take a handful of qīnghāo (sweet wormwood), soak in two shēng of water, wring out the juice, and drink it all.」 (「青蒿一握，以水二升渍，绞取汁尽服之。」)
1,700 years of time and space were bridged in that single moment — Gě Hóng could never have imagined that the single line of small characters he wrote at Luófú Shān (Mount Luofu) would, a thousand years later, save the lives of millions of African children.
📜 Wáng Shūhé and Modern Pulse Diagnosis
Today’s Chinese pulse diagnosis — cunkou three positions, six positions on both wrists, the twenty-four pulses — all derive from Wáng Shūhé’s Mai Jing. The research on pulse-diagnostic instruments in Taiwan, Japan, and Korea still has the Mai Jing as its foundational database.
🩺 Huángfǔ Mì and World Acupuncture
The 361 standard acupoints in the International Standard of Acupuncture Point Locations issued by the WHO in 1989 — the great majority of them come directly from the Zhenjiu Jiayijing and the Zhenjiu Dacheng — both books trace back to the lineage of Huángfǔ Mì.
🌏 Táo Hóngjǐng and the Bencao Gangmu
Lǐ Shízhēn’s (李时珍) Bencao Gangmu (《本草纲目》) with its sixteen-section classification is the culmination of Táo Hóngjǐng’s “seven-section classification”; in the General Rules of the Bencao Gangmu (《本草纲目·凡例》) Lǐ explicitly thanks Táo Hóngjǐng: “Since Táo Hóngjǐng’s Jizhu, classification has had its proper order」.
XV. Coda: How Could an Age of Chaos Lay the Foundations?
“Ages of upheaval produce heroes; ages of upheaval also produce great physicians.」
Why in an age when “white bones lay exposed in the fields,” did Chinese medicine instead complete its leap from “classics” to “techniques”?
🌱 Three Great Reasons
1. Pestilence Forged the Clinic
Death taught physicians how to live — Gě Hóng wrote the Zhouhou Beiji Fang, Zhāng Zhòngjǐng wrote the Shanghan Zabing Lun, precisely because both witnessed life and death in the great plagues.
2. Freedom of Thought
The intellectual shackles of the Han elevation of Confucianism as sole orthodoxy were broken by Wei–Jin Xuanxue, aristocratic families could make medicine their vocation, Daoists could pursue alchemy as their art — the opening of thought directly catalyzed an explosion of technique.
3. North–South Exchange
The Daoism, materia medica, and formularies of the South and the acupuncture, drug-pairing, and official schooling of the North achieved their great merger when the Sui unified the realm in 589 — and only then did the Tang’s “age of great physicians” become possible.
🪶 A One-Line Summary
“The Wei, Jin, and Northern and Southern Dynasties are the 370 years in which Chinese medicine moved from ‘bone’ to ‘flesh’; without these 370 years, there would be no Sui–Tang ‘age of great physicians,’ and still less the ‘art of Qihuang’ we have today.”
XVI. A Word from Qihuang Library
“Before him Zhòngjǐng, after him Sīmiǎo; in between, these 370 years saw Shūhé, Shì’ān, Zhìchuān, Yǐnjū, and countless other great physicians — with scroll after scroll, herb after herb, needle after needle — build Chinese medicine from a ‘classics’ into a ‘discipline.’」
Today, when we take the pulse — we are using Wáng Shūhé’s “twenty-four pulses”; when we select an acupoint — we are using Huángfǔ Mì’s “arrange by bodily region”; when we decoct a medicine — we are using Léi Xiào’s “seventeen methods of paozhi“; when we speak of “artemisinin” — we are remembering Gě Hóng’s “handful of qinghao”.
This is the Wei, Jin, and Northern and Southern Dynasties — the “foundation-laying age” of Chinese medicine.
“The Prime Minister of the Mountains returns to his mountain;
The Elder Gě, embracing simplicity, is content in himself;
Huángfǔ, lying ill, traced needles and brush on the page;
Shūhé by candlelight brought the Mai Jing to its form.」
Qihuang Library, together with you, will continue to walk through the Sui and Tang’s age of great physicians, continue through the Song, Jin, and Yuan’s hundred-schools contention, continue through the Ming and Qing’s great synthesis and the warm-disease school — walking the three-thousand-year road of Chinese medicine to its end.
In our next installment, we shall go to Tang-dynasty Cháng’ān (长安) to pay a visit to the one who, in the four characters “Great Physician, Sincere Dedication (大医精诚),” set the ethical standard of a millennium — the Medicine King, Sūn Sīmǐao (孙思邈).
📜 Qihuang lays foundations; amid chaos, merit is made;
The torch of the tradition has never gone out — it is carried into this very day.